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Nasal Response to Food Ingestion Challenge

Nasal Response to Food Ingestion Challenge Abstract • A routine diagnostic procedure, the food-focused history, intracutaneous tests with food extracts, and ingestion challenge with selected foods in combination with rhinomanometry were performed in 142 patients suffering from perennial allergic rhinitis. Forty-one of the 47 patients with a "positive food allergy history" developed 65 (90%) positive nasal responses during 72 food ingestion challenges. Of the 95 patients with an "unknown food allergy history," 54 developed 68 (50%) positive nasal responses during 132 food ingestion challenges. The following responses were recorded: 29 isolated immediate (within three hours), 38 isolated late (six to 24 hours), 42 dual late (immediate + late), 11 isolated delayed (28 to 52 hours), and 13 dual delayed (immediate + delayed). It can be concluded that the involvement of foods in allergic rhinitis is more frequent than is usually expected. The definite confirmation of the role of a certain food in these patients should be provided by the food ingestion challenge demonstrating one of the clinical types of nasal response. The mechanisms underlying the nasal response to foods are not yet fully clarified. The involvement of different types of hypersensitivity in the individual types of nasal response cannot be excluded. (Arch Otolaryngol Head Neck Surg 1988;114:525-530) References 1. Anderson JA, Sogn DD: Committee on adverse reactions to foods of the American Academy of Allergy and Immunology and National Institute of Allergy and Infectious Disease : Adverse Reactions to Foods , US Dept of Health and Human Services, National Institutes of Health publication 84-2442, 1984. 2. Bahna SL, Ghandi MD: Milk hypersensitivity: II. Practical aspects of diagnosis, treatment and prevention . Ann Allergy 1983;50:295-301. 3. Bernstein M, Day JH, Welsh A: Doubleblind food challenge in the diagnosis of food sensitivity in the adult . J Allergy Clin Immunol 1982;70:205-210.Crossref 4. Ogle KA, Bullock JD: Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: A five-year follow-up . Ann Allergy 1980;44:273-278. 5. Pelikan Z: The possible role of food allergy in patients with allergic rhinitis , in Abstracts of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, abstract 662. 6. Wraith DG: Asthma and rhinitis , in Brostoff J, Challacombe SJ (eds): Clinics in Immunology and Allergy—Food Allergy . Philadelphia, WB Saunders Co, 1982, pp 101-112. 7. Bernstein IL, Johnson CL, Gallagher JS, et al: Are tartrazine reactions mediated by IgE, abstracted . J Allergy Clin Immunol 1978; 61:191.Crossref 8. Eriksson NS: Food sensitivity reported by patients with asthma and hay fever . Allergy 1978;33:189-196.Crossref 9. Halpern GM: Alimentary allergy . J Asthma 1983;20:251-284.Crossref 10. Pelikan Z: Late and delayed nasal mucosa response to allergen challenge . Ann Allergy 1978; 41:37-47. 11. Pelikan Z: The role of immediate, late and delayed reactions in allergic nasal disease , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 772-777. 12. Pelikan Z, Pelikan-Filipek M: The effects of disodium cromoglycate on the immediate and late nasal mucosa response to allergen challenge , in Abstracts of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, abstract 098. 13. Pelikan Z, Pelikan-Filipek M: The effects of disodium cromoglycate and beclomethasone dipropionate on the immediate response of the nasal mucosa to allergen challenge . Ann Allergy 1982;49:283-292. 14. Pelikan Z: The effects of disodium cromoglycate and beclomethasone dipropionate on the late nasal mucosa response to allergen challenge . Ann Allergy 1982;49:200-212. 15. Pelikan Z: The diagnostic approach to the immediate hypersensitivity in patients with allergic rhinitis: A comparison of nasal challenges and serum RAST . Ann Allergy 1983; 59:283-292. 16. Pelikan Z, Pelikan M: The protective effects of disodium cromoglycate (DSCG, Nalcrom) in food allergy, in Abstracts of the Annual Meeting of the European Academy of Allergology and Clinical Immunology. Brussels, European Academy of Allergology and Clinical Immunology, 1984, p 161. 17. Pelikan Z: The changes in the nasal secretions of eosinophils during the immediate nasal response to allergen challenge . J Allergy Clin Immunol 1983;72:657-662.Crossref 18. Pelikan Z: Food ingestion challenge: A comparison of double-blind and open challenge in patients with atopic eczema, rhinitis, bronchial asthma and migraine, in Proceedings of the Sixth International Food Allergy Symposium, Boston, Nov 13-19, 1987. Boston, American College of Allergologists, 1987, abstract 17, p 109. 19. May CD, Bock SA: Adverse reactions to foods due to hypersensitivity , in Middleton E Jr, Reed CE, Ellis EF (eds): Allergy, Principles and Practice . St Louis, CV Mosby Co, 1978, pp 1159-1171. 20. Bock S, May D, Remigio L: Clinical manifestations and immunological findings in food sensitivity confirmed objectively , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 411-415. 21. Pelikan Z, Pelikan M: Bronchus obstructive response to the food ingestion challenge , in Proceedings of the Fifth Charles Blackley Symposium on the Clinical Aspects of Allergic Disease . Nottingham, England, Derby, MAARA, 1984. 22. Moneret-Vautrin DA: Non specific reactions to foodstuffs , in Kerr JW, Ganderton MA (eds): Proceedings of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, pp 175-179. 23. Schlumberger HD: Pseudo-allergic reactions to drugs and chemicals . Ann Allergy 1983; 51:317-324. 24. Baker GJ, Collet P, Allen DH: Bronchospasm induced by metabisulfite containing foods and drugs . Med J Aust 1981;2:614-616. 25. Weber RW, Hoffman M, Raine DA, et al: Incidence of bronchoconstriction due to aspirin, azo-dyes and preservatives in a population of perennial asthmatics . J Allergy Clin Immunol 1979;64:32-37.Crossref 26. Gerard JW: The diagnosis of the food allergic patient , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 416-421. 27. Sampson HA, Albergo R: Comparison of results of skin tests, RAST and double-blind, placebo controlled food challenges in children with atopic dermatitis . J Allergy Clin Immunol 1984;74:26-33.Crossref 28. Atkins FM, Steinberg SS, Metcalfe DD: Evaluation of immediate adverse reactions to foods in adult patients: I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challenge . J Allergy Clin Immunol 1986;75:348-355.Crossref 29. Atkins FM, Steinberg SS, Metcalfe DD: Evaluation of immediate adverse reactions to foods in adult patients: II. A detailed analysis of reaction patterns during oral food challenge . J Allergy Clin Immunol 1986;75:356-363.Crossref 30. Heiner DC: Food allergy and respiratory disease . Ann Allergy 1983;51:273-274. 31. Zanussi C, Ortolain C, Pastorello E: Dietary and pharmacologic management of food intolerance in adults . Ann Allergy 1983;51:307-310. 32. American Academy of Allergy: Position statements—controversial techniques . J Allergy Clin Immunol 1981;67:333-338.Crossref 33. Aas K: The critical approach to food allergy . Ann Allergy 1983;51:256-259. 34. Sachs MI: Value of food antigen specific IgE-RAST and immediate reaction skin tests . Ann Allergy 1983;51:264-266. 35. Hoffman DR, Haddad ZH: Diagnosis of IgE-mediated reactions to food antigens by radioimmunoassay . J Allergy Clin Immunol 1974; 54:165-173.Crossref 36. Adkinson NF: The radioallergosorbent test in 1981: Limitations and refinements . J Allergy Clin Immunol 1981;67:87-89.Crossref 37. Goldman AS, Anderson DW Jr, Sellers WA, et al: I. Oral challenge with milk and isolated proteins in allergic children . Pediatrics 1963;32:425-443. 38. Wilson CMW: Food sensitivities, taste changes, aphthous ulcers and atopic symptoms in allergic disease . Ann Allergy 1980;44:302-307. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Nasal Response to Food Ingestion Challenge

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1988.01860170055018
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Abstract

Abstract • A routine diagnostic procedure, the food-focused history, intracutaneous tests with food extracts, and ingestion challenge with selected foods in combination with rhinomanometry were performed in 142 patients suffering from perennial allergic rhinitis. Forty-one of the 47 patients with a "positive food allergy history" developed 65 (90%) positive nasal responses during 72 food ingestion challenges. Of the 95 patients with an "unknown food allergy history," 54 developed 68 (50%) positive nasal responses during 132 food ingestion challenges. The following responses were recorded: 29 isolated immediate (within three hours), 38 isolated late (six to 24 hours), 42 dual late (immediate + late), 11 isolated delayed (28 to 52 hours), and 13 dual delayed (immediate + delayed). It can be concluded that the involvement of foods in allergic rhinitis is more frequent than is usually expected. The definite confirmation of the role of a certain food in these patients should be provided by the food ingestion challenge demonstrating one of the clinical types of nasal response. The mechanisms underlying the nasal response to foods are not yet fully clarified. The involvement of different types of hypersensitivity in the individual types of nasal response cannot be excluded. (Arch Otolaryngol Head Neck Surg 1988;114:525-530) References 1. Anderson JA, Sogn DD: Committee on adverse reactions to foods of the American Academy of Allergy and Immunology and National Institute of Allergy and Infectious Disease : Adverse Reactions to Foods , US Dept of Health and Human Services, National Institutes of Health publication 84-2442, 1984. 2. Bahna SL, Ghandi MD: Milk hypersensitivity: II. Practical aspects of diagnosis, treatment and prevention . Ann Allergy 1983;50:295-301. 3. Bernstein M, Day JH, Welsh A: Doubleblind food challenge in the diagnosis of food sensitivity in the adult . J Allergy Clin Immunol 1982;70:205-210.Crossref 4. Ogle KA, Bullock JD: Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: A five-year follow-up . Ann Allergy 1980;44:273-278. 5. Pelikan Z: The possible role of food allergy in patients with allergic rhinitis , in Abstracts of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, abstract 662. 6. Wraith DG: Asthma and rhinitis , in Brostoff J, Challacombe SJ (eds): Clinics in Immunology and Allergy—Food Allergy . Philadelphia, WB Saunders Co, 1982, pp 101-112. 7. Bernstein IL, Johnson CL, Gallagher JS, et al: Are tartrazine reactions mediated by IgE, abstracted . J Allergy Clin Immunol 1978; 61:191.Crossref 8. Eriksson NS: Food sensitivity reported by patients with asthma and hay fever . Allergy 1978;33:189-196.Crossref 9. Halpern GM: Alimentary allergy . J Asthma 1983;20:251-284.Crossref 10. Pelikan Z: Late and delayed nasal mucosa response to allergen challenge . Ann Allergy 1978; 41:37-47. 11. Pelikan Z: The role of immediate, late and delayed reactions in allergic nasal disease , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 772-777. 12. Pelikan Z, Pelikan-Filipek M: The effects of disodium cromoglycate on the immediate and late nasal mucosa response to allergen challenge , in Abstracts of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, abstract 098. 13. Pelikan Z, Pelikan-Filipek M: The effects of disodium cromoglycate and beclomethasone dipropionate on the immediate response of the nasal mucosa to allergen challenge . Ann Allergy 1982;49:283-292. 14. Pelikan Z: The effects of disodium cromoglycate and beclomethasone dipropionate on the late nasal mucosa response to allergen challenge . Ann Allergy 1982;49:200-212. 15. Pelikan Z: The diagnostic approach to the immediate hypersensitivity in patients with allergic rhinitis: A comparison of nasal challenges and serum RAST . Ann Allergy 1983; 59:283-292. 16. Pelikan Z, Pelikan M: The protective effects of disodium cromoglycate (DSCG, Nalcrom) in food allergy, in Abstracts of the Annual Meeting of the European Academy of Allergology and Clinical Immunology. Brussels, European Academy of Allergology and Clinical Immunology, 1984, p 161. 17. Pelikan Z: The changes in the nasal secretions of eosinophils during the immediate nasal response to allergen challenge . J Allergy Clin Immunol 1983;72:657-662.Crossref 18. Pelikan Z: Food ingestion challenge: A comparison of double-blind and open challenge in patients with atopic eczema, rhinitis, bronchial asthma and migraine, in Proceedings of the Sixth International Food Allergy Symposium, Boston, Nov 13-19, 1987. Boston, American College of Allergologists, 1987, abstract 17, p 109. 19. May CD, Bock SA: Adverse reactions to foods due to hypersensitivity , in Middleton E Jr, Reed CE, Ellis EF (eds): Allergy, Principles and Practice . St Louis, CV Mosby Co, 1978, pp 1159-1171. 20. Bock S, May D, Remigio L: Clinical manifestations and immunological findings in food sensitivity confirmed objectively , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 411-415. 21. Pelikan Z, Pelikan M: Bronchus obstructive response to the food ingestion challenge , in Proceedings of the Fifth Charles Blackley Symposium on the Clinical Aspects of Allergic Disease . Nottingham, England, Derby, MAARA, 1984. 22. Moneret-Vautrin DA: Non specific reactions to foodstuffs , in Kerr JW, Ganderton MA (eds): Proceedings of the 11th International Congress of Allergology and Clinical Immunology . London, Macmillan Publishers Ltd, 1982, pp 175-179. 23. Schlumberger HD: Pseudo-allergic reactions to drugs and chemicals . Ann Allergy 1983; 51:317-324. 24. Baker GJ, Collet P, Allen DH: Bronchospasm induced by metabisulfite containing foods and drugs . Med J Aust 1981;2:614-616. 25. Weber RW, Hoffman M, Raine DA, et al: Incidence of bronchoconstriction due to aspirin, azo-dyes and preservatives in a population of perennial asthmatics . J Allergy Clin Immunol 1979;64:32-37.Crossref 26. Gerard JW: The diagnosis of the food allergic patient , in Pepys J, Edwards AM (eds): The Mast Cell—Its Role in Health and Disease . Marshfield, Mass, Pitman Publishers Inc, 1979, pp 416-421. 27. Sampson HA, Albergo R: Comparison of results of skin tests, RAST and double-blind, placebo controlled food challenges in children with atopic dermatitis . J Allergy Clin Immunol 1984;74:26-33.Crossref 28. Atkins FM, Steinberg SS, Metcalfe DD: Evaluation of immediate adverse reactions to foods in adult patients: I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challenge . J Allergy Clin Immunol 1986;75:348-355.Crossref 29. Atkins FM, Steinberg SS, Metcalfe DD: Evaluation of immediate adverse reactions to foods in adult patients: II. A detailed analysis of reaction patterns during oral food challenge . J Allergy Clin Immunol 1986;75:356-363.Crossref 30. Heiner DC: Food allergy and respiratory disease . Ann Allergy 1983;51:273-274. 31. Zanussi C, Ortolain C, Pastorello E: Dietary and pharmacologic management of food intolerance in adults . Ann Allergy 1983;51:307-310. 32. American Academy of Allergy: Position statements—controversial techniques . J Allergy Clin Immunol 1981;67:333-338.Crossref 33. Aas K: The critical approach to food allergy . Ann Allergy 1983;51:256-259. 34. Sachs MI: Value of food antigen specific IgE-RAST and immediate reaction skin tests . Ann Allergy 1983;51:264-266. 35. Hoffman DR, Haddad ZH: Diagnosis of IgE-mediated reactions to food antigens by radioimmunoassay . J Allergy Clin Immunol 1974; 54:165-173.Crossref 36. Adkinson NF: The radioallergosorbent test in 1981: Limitations and refinements . J Allergy Clin Immunol 1981;67:87-89.Crossref 37. Goldman AS, Anderson DW Jr, Sellers WA, et al: I. Oral challenge with milk and isolated proteins in allergic children . Pediatrics 1963;32:425-443. 38. Wilson CMW: Food sensitivities, taste changes, aphthous ulcers and atopic symptoms in allergic disease . Ann Allergy 1980;44:302-307.

Journal

Archives of Otolaryngology - Head & Neck Surgery – American Medical Association

Published: May 1, 1988

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